Treating GI reflux with a prosthesis

The antireflux prosthesis has had excellent results and simplified surgical treatment of this condition. At about 20 minutes, actual operative time is considerably reduced compared with traditional hiatal hernia repairs. From 1973 to 1982, 174 patients underwent surgery with a specified follow-up series of UGI radiological studies. There were no mortalities related to the prosthesis. Three patients had the prosthesis removed. Complications related to the prosthesis included its displacement in one patient in whom the knot slipped. The prosthesis was replaced with excellent results. In one instance, a spleen laceration necessitated a splenectomy. Fifty patients experienced transient dysphagia for two to six weeks or longer but with no problems after the dysphagia subsided. Twenty-three were determined through x-ray to have had the prosthesis migrate above the diaphragm due to a large hiatus. In all of these 23 patients, the prosthesis remained at the gastroesophageal junction, and they remained asymptomatic. Perioperative nursing care and teaching closely follows that of traditional hiatal hernia repair with a shorter and less traumatic recovery.